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Restless Legs Syndrome

Restless legs syndrome is a neurological sleep disorder that make you have an overwhelming urge to move your legs. Restless legs syndrome makes it difficult to get comfortable enough to fall asleep. The symptoms are usually worse at night. The sensation is difficult for some people to describe. You may lie down and begin to feel burning or itching inside your legs. If you move your legs or get up and walk around, these symptoms may go away. The discomfort may return when you try again to go to sleep.
In some restless legs syndrome cases, you may have trouble sitting still for long periods of time. Long car rides or airplane travel may be difficult.
Many people wait years to seek treatment because they do not view it as a serious concern. If left untreated, you may notice that your symptoms become more frequent and severe.
Restless legs syndrome may cause you to get fewer hours of sleep each night. Many people with severe cases get less than five hours of sleep per night. Milder cases do not disturb your sleep as much, though the sleep may be of poorer quality.
The accumulated sleep loss from restless legs syndrome can make you excessively sleepy during the daytime, cause you to be irritable and make concentration difficult. This may have a major impact on your professional and personal life. People with restless legs syndrome are more likely to have depression or anxiety.
Restless legs syndrome is almost always manageable through medication and a number of lifestyle changes.
Most people develop restless legs syndrome after age 45. Women are nearly twice as likely as men to develop the disorder. If you have a family member with restless legs syndrome, you are more likely to develop the symptoms before you are 45 years old. More than half of people with restless legs syndrome have a pattern of it in their family, as the risk is about three to six times greater.
Restless Legs Syndrome – Causes & Symptoms
Causes
What causes of restless legs syndrome varies from person to person. In some cases the cause is unknown, or it can be caused by or made worse by other health issues or medication. This may include:
Low iron levels
This can cause problems with brain cell communication that can lead to restless legs syndrome. If you think you have restless legs syndrome caused by low iron, talk with your physician and do not attempt to take supplements on your own.
Diabetes
This lifelong condition can damage blood vessels and nerves that affect leg muscles causing restless legs syndrome. By properly managing your diabetes, you may help prevent or improve your restless legs syndrome.
Pregnancy
Many women have restless legs syndrome when they are pregnant. It usually goes away within a month of giving birth.
Medications
Some medications can cause restless legs syndrome or make it worse:
• Allergy medications
• Many antidepressants
• Antihistamines and over-the-counter sleep aids
• Nearly all centrally active dopamine-receptor antagonists, including anti-nausea medications
Symptoms
The primary symptom of restless legs syndrome is a sensation of discomfort in the legs that often defies description. The feeling is different than leg cramps or numbness from circulation problems. Patients have used the following words to describe this sensation:
• Itchy
• Crawling
• Burning
• Creepy
• Throbbing
Usually this feeling is paired with the urge to move your legs. The desire usually worsens when you lie down or rest.
The symptoms of restless legs syndrome are frequently worse at night than in the morning.
A related problem is that your leg muscles might tighten or flex while you are still. These movements can be out of your control. In extreme cases, they may be periodic limb movements.
Restless Legs Syndrome – Self-Tests & Diagnosis
Self-Tests
Do you have difficulty falling asleep because you of an urge to move your legs?
Do you wake up at night because you feel like your legs are on fire?
Do you feel an itching in your legs when you lie down to go to sleep?
Do your legs seem to feel better when you walk, stretch or make other movements?
If you answered yes to any of these questions you may have restless legs syndrome
Diagnosis
Talk to a board certified sleep medicine physician if you think you have restless legs syndrome. The physician will ask you about your medical history and if you are on any medications. He or she can refer you to a sleep medicine physician if necessary.
The sleep physician may ask that you keep a sleep diary for two weeks to show when you sleep and for how long. You may also rate your how sleep is affecting your daily life using the Epworth Sleepiness Scale. Make sure to tell the sleep medicine physician if you or a relative have ever had a sleep disorder.
Your doctor may order blood tests, including measuring iron. In some cases he may recommend a sleep study.
A sleep study may be used to ensure that you do not have obstructive sleep apnea or other sleep disorders that may be causing sleep disruption. This is helpful but is not required to diagnose restless legs syndrome
Restless Legs Syndrome – Treatment
The board certified sleep physician may recommend lifestyle changes, medications or a combination to manage your restless legs syndrome.
Behavioral Changes
Behavioral changes to help restless legs syndrome include:
Exercise
Regular exercise such as walking or riding an exercise bike may relieve the symptoms of restless legs syndrome. Exercising too much or at too great of an intensity can actually increase symptoms.
Stress Reduction Techniques
Stress can aggravate restless legs syndrome. Relaxation-promoting activities such as yoga, meditation or other techniques can reduce the symptoms. This approach is especially helpful before bed.
Quit smoking and drink less caffeine and alcohol
Each of these may worsen the symptoms of restless legs syndrome. By avoiding these substances, you may be able to help your restless legs syndrome.
Massage your legs or soak in a hot bath
Both of these can help relax your muscles and alleviate the symptoms of restless legs syndrome.
Medications

There are a variety of medications available to treat restless legs syndrome. You may take one medication or a combination of drugs for your restless legs syndrome.
Parkinson’s disease medications
These drugs replace a chemical in your brain called dopamine. If you have restless legs syndrome, you are not at increased risk for Parkinson’s disease. However, the same medications used to treat Parkinson’s disease are often helpful in treating restless legs syndrome.
Sleeping pills
Hypnotic sleeping pills may help you fall asleep more easily.
Certain anti-seizure medications
Drugs used for the treatment of epilepsy may help treat restless legs syndrome.
Narcotic pain medications
Opoids such as codeine or oxycodone can relieve symptoms of restless legs syndrome. These drugs have a risk of addiction.
Iron treatment
If tests show you have an iron deficiency, a doctor may recommend that you take a supplement. Do not take iron without a doctor’s advice. Too much iron can be harmful for your liver.

In some cases, you may build a tolerance to the medications over time. When this happens you will need to talk to your doctor, who may recommend that you change your medication.